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LU N C L i n ecb e r g e ria C o mnpnr e h e n seicv e C aesn c e r Cre n t e r The Cancer Program of UNC-Chapel Hill & UNC Health Care Spring 2004
Putting Out
Youth Tobacco Use
Reducing and preventing
tobacco use is a touchy sub-ject
for North Carolinians.
Long before becoming famous
for superior collegiate basket-ball,
North Carolina was
known simply as Tobacco
Road.
Cigarette smoking is the
nation’s leading cause of pre-mature
sickness and death,
accounting for over 400,000
deaths each year. More than
47 million adults and 4 mil-lion
teenagers smoke.
The use of tobacco is par-ticularly
troubling among young people. Research from the
Centers for Disease Control and Prevention found that every
day more than 4,000 Americans between the ages of 12 and
17 try their first cigarettes. And while smoking is declining
among all other age groups, it remains high among 18 to 24
year olds, rising 23 percent between 1991 and 2001.
Researchers at UNC Lineberger are helping to combat
these rising statistics. Here’s a look at some of the tobacco-related
projects under way.
Influencing Childhood Decisions:
Stopping Youth Smoking Before It Starts
Evidence from an eight-year study by Christine Jackson,
associate professor of health behavior and health education,
showed that the more cigarettes a child smoked at an early
the inside line up ...
5Answers &
Support on
the Web
2Director’s
Message
age, the more likely they were to be a daily smoker as a teen.
The study included 737 children from central North Caro-lina.
Their cigarette use was measured at ages 8 and 10 and
again at age 17.
“This study was the first to examine whether cigarette use
in early childhood was associated with all levels of smoking
in adolescence or with nicotine-dependent (daily) use speci-fically,”
Jackson explains. The study investigated what level
of cigarette use in childhood increased the odds of smoking
in adolescence.
Among those who did not smoke any cigarettes in early
childhood, 10 percent became daily smokers by age 17,
whereas 39 percent of those who smoked more than 20 ciga-
4Profile: Sartor
& Briefs
eHealth
10New NC Cancer
Hospital Plans &
Calendar of
Events
continued on page 3
6Lineberger
Scrapbook
Researchers Breathe Life into
Anti-Tobacco Initiatives forYoung People
Kurt Ribisl and UNC Tobacco Use and Prevention and Control Training Project
members look over tobacco products obtained by underage youth over the Inter-net.
Pictured above left to right: Kurt Ribisl, Rebecca Williams, Annice Kim,
and Sarah Pearcy.
35.8% currently use some tobacco product
27.8% currently smoke cigarettes
47.5% live in homes where someone smokes
73.4% were in the same room with someone who was smoking
on one or more days in the week that preceded the survey
NC High School Students Tobacco Use NC Middle School Students Tobacco Use
17.4% currently use some tobacco product
11.3% currently smoke cigarettes
47.1% live in homes where someone smokes
55.5% were in the same room with someone who was smoking
on one or more days in the week that preceded the survey
Source: 2001 NC Youth Tobacco Survey
creased 35 percent in the last six
years, and as the population of our
state grows and grays, those numbers
will rise significantly.
The New Hospital:
How would it benefit North Carolina
citizens?
• more room for a growing patient
population
• specially designed facilities for high-technology
tumor imaging, genetic analysis, and novel
treatments
• incorporating amenities and support services
for all patients.
• enhanced clinical research and innovative care
options
• teleconferencing facilities to include community-based
physicians in treatment planning for their
patients, allowing most treatments to be continued
in their home communities.
• pairing cancer care with a preventive clinic
focused on surviving patients and their families as
well as high-risk individuals and their families
A new NC Cancer Hospital will harness the
power of genetics and technology, the
foundation of the future individualized cancer
care. In the hands of skilled and compas-sionate
physicians, these developments will
drive both the standard of care and the clinical
research agenda at world-class institutions.
The NC Cancer Hospital, complete with a
nationally recognized clinical and prevention
research agenda, will bring this to all citizens of
North Carolina.
Leadership Change at UNC Heath Care
Ending on a personal note I will certainly miss
working with Jeff Houpt, my Dean and Health
System CEO for the last seven years. Jeff’s
legacy of facility improvements is all around us
and his outstanding leadership appointments
have helped build a world class cancer center.
At the same time I am very pleased with the
appointment of Bill Roper as Jeff’s replace-ment.
In the past, Dr. Roper headed both the
nation’s Medicare program and Centers for
Disease Control and Prevention in Atlanta. For
the last seven years he was a great Lineberger
friend in his role as Dean of the UNC School
of Public Health. He is determined to expand
on Jeff Houpt’s legacy, bringing the best in
prevention, early detection and health care to
North Carolina.•
2 cancerLines Spring 2004
UNC Lineberger is designated a
comprehensive cancer center by the
National Cancer Institute.
Cancer Lines is a semi-annual
publication of the UNC Lineberger
Comprehensive Cancer Center,
The University of North Carolina
School of Medicine at Chapel Hill.
Dr. H. Shelton Earp, III, Director
Dr. Joseph S.Pagano, Director Emeritus
Debbie Dibbert, Director of
External Affairs
Dianne G. Shaw, Director of
Communications/Executive Editor
Margot Carmichael Lester, Editor
Please remove me from your
mailing list
Name
Please add the following to the
Cancer Center’s mailing list.
Name
Address
City, State, Zip
UNC Lineberger
Comprehensive Cancer Center
CB# 7295
School of Medicine
University of North Carolina at
Chapel Hill
Chapel Hill, NC 27599-7295
(919) 966-3036
http://unclineberger.org
Printed on Recycled Paper
MeDsisreactgor’es
Every five years, the
National Cancer In-stitute
evaluates the
progress of each
comprehensive can-cer
center and ad-justs
the federal bud-get
supporting the
Center’s research
and infrastructure.
This so-called NCI
core funding is one
of the largest grants
at UNC Chapel Hill,
and the process, sim-ply
because of its importance, is a “nail biter.”
To prepare for this five-year review we initiated a
strategic planning process.
During the last twelve months our program
leaders involved virtually all 235 Cancer Center
members in a stimulating exercise to plot the
course of cancer discovery at UNC. First, we
challenged the faculty to think broadly about
what discoveries and strategic directions are
likely to make an impact on cancer over the
next five to ten years. Next, we considered
what we at UNC do best and how we could
apply our strengths to the faculty’s prediction
of pivotal and strategic directions. Lastly, we
asked ourselves whether there are some areas
that are just so important that we need to
build, if necessary from scratch, to supplement
our current strengths.
What makes our Cancer Center and this
planning process so unique is the tremendous
breadth of our membership; they represent so
many disciplines across societal and biomedi-cal
research. If you were to tour the UNC cam-pus
to find Cancer Center members, you would
start near the arboretum at the Department of
Psychology, turn left at the Old Well to walk
through Polk Place with the School of Infor-mation
and Library Science on your left and
the Schools of Journalism and Computer
Science on your right. Then you would wind
up Columbia Street past Chemistry, Biology,
the Schools of Pharmacy, Nursing, and Public
Health, before turning on Manning Drive past
the home of one of the greatest medical
sciences faculties in the country, and end up
at the door of our clinical facilities at UNC
Hospitals.
It is our goal to combine all these strengths
and be a major contributor in the national and
international fight against cancer. The first step
was our completed 10-page strategic plan; re-sulting
from the above process; the second
step, an NCI grant request, extolling our vir-tues
and laying out an increased budget in a
“succinct” 1,700 page document, weighing 36
pounds, and measuring 701 cubic inches. On
May 26, some of the nation’s best scientists will
come to Chapel Hill to assess our strategy for
the next five years. We are confident that we
have right stuff, and we will let you how we do.
The New NC Cancer Hospital:
A Growing Need
Speaking of those clinical facilities, the num-ber
of cancer patients coming to UNC Line-berger
seeking treatment is increasing dra-matically.
We appreciate their confidence and
trust in our physicians, nurses and our multi-disciplinary
approach. They love the care that
they receive, but not the facilities in which it is
delivered.
Many of the advances in cancer diagnostics
and therapy you learn about from the media
are available at UNC, but it’s difficult to pro-vide
leading-edge technology and therapies in
a clinical center occupying a vintage 1950’s
tuberculosis sanatorium facility. We have reno-vated
as much as we can to make the space
safe and functional for our staff and patients,
but we’re out of room. We need a new facility!
As the public cancer center for the people
and state of North Carolina, we hold ourselves
to a high standard of care; achieving this goal
is increasingly difficult in our antiquated build-ing.
Our cancer patient numbers have in-
Dr. H. Shelton Earp, III
About 40,000 people develop rectal cancer in the
United States every year; however, rectal cancer
therapy is currently less than ideal, concedes Ben
Calvo, chief of the division of surgical oncology and
GI cancer program leader for UNC Lineberger.
Although substantial progress has been made,
about 40 percent of patients with rectal cancer will
eventually die of their disease, and many more will
have substantial side effects from the therapy.
In the past, most patients with rectal tumors
close to the anus required an abdominal perineal
resection, where both the rectum and anus were
resected and resulted in patients having a perma-nent
colostomy. Treatment with a combination of
radiation and chemotherapy prior to surgery can
reduce tumor size in about 30 percent of patients
and more frequently allows for operations where
the anus is preserved, thus obviating the need for
a colostomy—surgery to form an artificial anal
opening in the body from the colon.
The UNC Lineberger multidisciplinary GI cancer
team includes medical oncologists (Richard Gold-berg,
Steve Bernard, Bert O’Neil), surgeons (Ben
Calvo, H.J. Kim, Michael Meyers), radiation oncol-
UNC Lineberger Multi-disciplinary
GI Team
Use Innovative Research
to Treat Rectal Tumors
ogists ( Joel Tepper, Lav Goyal), and laboratory
scientists (Chuck Perou, Al Baldwin). One of the
main research objectives for this team is to increase
the percentage of tumors that will shrink with com-bination
chemo and radiation treatment. This
would improve the chances of rectal preservation
as well as maintaining the function of surrounding
organs such as the bladder and sexual function.
UNC Lineberger
GI cancer experts
discuss the
protocol. Left to
right: Drs. Joel
Tepper, Bert
O’Neil, Ben
Calvo, H.J. Kim
and Michael
Meyers.
continued on page 8
rettes as young children became daily smokers.
“This study provides important prospective evi-dence
that relatively small increases in the number
of cigarettes smoked during childhood are associ-ated
with substantial increases in the proportion of
youth reporting smoking at late adolescence,” she
says. The study is also characterizing the relations
between parental smoking habits and early
childhood smoking.
Surfing for Smokes
Another concern: kids’ access to cigarettes on the
Internet. Weak or nonexistent age verification
methods make it easy for youngsters to make illegal
purchases. Kurt Ribisl was the first researcher to
scientifically investigate Internet cigarette sales to
minors. Ribisl is assistant professor of health
behavior and health education in the School of
Public Health and program director for the UNC
Pre-doctoral Tobacco Use Prevention and Control
Training Program.
His study employed four children aged 11 to 15
whose activities were supervised by adults. “The
kids made 83 purchase attempts, paying by credit
card 47 times and by money order 36 times,”
Ribisl explains. “The Internet vendors sent a total
of 1,650 packs of cigarettes to these underage
youth—and age was never verified for any of
them.”
So why not shut down these vendors? Simple,
Ribisl says. “There’s no federal law that bans Inter-net
and mail order cigarette sales to minors and
only six states prohibit it. Thus, none of the Web
sites in this study was breaking any federal laws by
selling to children.
��Our study clearly shows that Internet cigarette
vendors are not adequately verifying the age of
their customers and that federal action is urgently
needed. Pornography sites probably do a better
job of verifying the ages of their customers than
Web sites selling cigarettes.”
Youth Empowerment
Programs
Smoke-free environments are crucial to reducing
and preventing tobacco use among teens. That’s the
principle behind the Tobacco-Free Schools (TFS)
initiative. According to the Centers for Disease Con-trol
and Prevention, a TFS “bans all tobacco use by
students, all school staff, and visitors on school
property, in school vehicles, and at school functions
away from school property.”
Kurt Ribisl is involved in this effort as well.
“Studies have shown that school smoking restric-tions
are worth pursuing. The student smoking rates
at schools that have and enforce smoking restric-tions
are 11 percent lower than at schools without
smoking restrictions,” says Ribisl, principal invest-igator
for the NC Youth Empowerment Study (NC
YES), a research project designed to evaluate youth-led,
adult-supported programs that create effective
policies and activities to reduce tobacco use.
Unfortunately, only 16 percent of NC school
districts are smoke-free, says Ribisl. To improve that
number, NC YES examined how 15 districts
secured passage of 100 percent tobacco-free school
policies. Those tactics will be shared with other
schools in an effort in improve their efforts at
passage.
Anti-Tobacco Initiatives
continued from page 1
cancerLines Spring 2004 3
Activist shares life story,
anti-tobacco message with kids
Gary Miner, a cigarette smoker of over 35
years, developed throat cancer in 1999. But
even after his initial diagnosis and a grim
forecast, Miner continued the habit—or
addiction, as he likes to call it.
It wasn’t until he entered UNC Hospitals
for his laryngectomy in
2000 that Miner decided
he needed to change. He
smoked a pack of cig-arettes
before leaving for
the surgery, but once he
set foot into the facility,
his attitude changed.
Miner’s surgery re-moved
his voice box and
half of his throat, taking
away his ability to talk
without the aid of an
electronic voice box, as
well as his senses of taste and smell.
The combined impact of these physical
changes compelled him to become an advo-cate
for tobacco use prevention.
“I had a drive that just kept on eating at
me,” Miner said. “I knew one day I’d leave
work and speak to every kid and talk to them
about the hazards of tobacco.”
Miner left his job as director for the
Marine Corps’ East Coast Regional Devel-opment
Center and pursued his new career.
He traveled throughout the state with his
wife, Janet, promoting his own tobacco
cessation program.
“The school kids told me I had a great mes-sage,
but needed to do something about it,”
Miner said. “During our talk, they said we
should have started the program yesterday.”
As a result, he founded Students Teaching
Resistance Information 2 Kids Everywhere
(Strike2) for students in Onslow County.
Now in its third year, Strike2 has trained
46 high school students and hopes to expand
to all eight Onslow County high schools. Stu-dents
at each high school educate children in
middle and elemen-tary
schools and
produce programs
to spread the word.
When he can,
Miner attends the
educational ses-sions.
To drive his
point home, he
struggles for breath
as he presses a
rubber valve in his
throat to activate his
voice box, which produces a startling sound.
The kids are always speechless.
Strike2 is having an impact. The group
created an anti-tobacco public service
announcement that began airing on
Jacksonville-area television stations in March
and convinced the Onslow County board of
education to declare its district smoke-free.
With the program in full swing, Miner is
spreading his influence to a wider audience.
He and Janet are back on the road, traveling
throughout North America to reach more
young people with his message. Last year,
they visited schools in 32 states and Canada.
Miner sees his experience with throat
cancer as an opportunity to keep others from
similar outcomes.
“All we’re trying to do is deliver a message
that tobacco can and will harm your body,”
Miner says.“Why take the chance?”
Gary and Janet Miner
Tackling Smoking
Smoking at high school athletic events is also tar-geted
via the Tackle Smoking Project. This project,
led by Eric Pevzner, a doctoral student in health
behavior and health education in the School of
Public Health, examines TFS compliance at foot-ball
games. On average, observers recorded far
fewer instances of smoking at games at TFS schools
than they did at non-TFS schools. The lower rate is
attributed in part to no-smoking signs and public
announcements in stadiums to inform spectators
of the policy.
Pevzner has expanded the study to determine if
supplemental signage, public announcements and
warnings by security staff will decrease the amount
of smoking and exposure to secondhand smoke at
high school football games.•
UNC Lineberger has changed its web address
Our new address is
www.unclineberger.org.
The old address
(http://cancer.med.unc.edu)
still works, but we thought
the new address
might be easier to remember.
and in trials with patients who have the
most aggressive breast cancers, despite
having full surgical, chemo and radiation
treatments.”
Navigating Medicine
The daughter of a systems analyst/home-maker
and an engineer, Sartor says,
“Medicine was always held up to be an
honorable profession. That reputation
pulled me in more than anything.”
Though always interested in medicine
as a career, Sartor didn’t originally pursue
oncology.“I was intrigued by neurosurgery, mostly
because I’d never met or seen a neurosurgeon,” she
admits.
She studied biomedical sciences in college at
the University of Michigan and decided on oncol-ogy
there. That’s also where she met her husband,
Nick, during college orientation.
“We were hating the winters,” she recalls. “We
went to a movie with a leader about North Caro-lina.”
Two things about the state were hard to resist:
“the phenomenal experts in my area like Ed Liu,
Bev Mitchell and Shelley Earp; and great sailing.”
An avid sailor, Sartor has three boats and sails
whenever possible. She and her husband spent a
year sailing the inland waterway from Michigan to
Florida. Her ideal trip: “Sailing the coast of Spain.
But I also love the Intracoastal Waterway.”
4 cancerLines Spring 2004
Combination Treatment Helps
Patients With Advanced Colorectal
Cancer
Results of a five-year study of 795 advanced colo-rectal
cancer patients show that a new combination
of chemotherapy drugs, known as FOLFOX 4, out-performs
the standard chemotherapy treatment.
Patients receiving the new combination lived an
average of 19.5 months after beginning treatment,
the study found, compared to 14.8 months for
patients receiving the standard IFL treatment.
FOLFOX 4 patients also had fewer serious side
effects such as infections, diarrhea and vomiting
and severe hair loss.
FOLFOX 4 is a chemotherapy regimen in-cluding
the recently approved drug oxaliplatin
(Eloxatin) combined with 5-Fluorouracil. IFL is a
treatment which uses the chemotherapy drugs
irinotecan (Camptosar, CPT-11) with 5-FU and
leucovorin.
“This is the greatest increase in survival time re-corded
to date with a new treatment used by
patients enrolled in a large
randomized study of colo-rectal
cancer in the United
States,” says Richard Gold-berg,
the study’s lead re-searcher,
and the Lineberger
Center’s associate director.
“Based on these findings, we conclude that the
FOLFOX 4 treatment should be considered as a
first-line treatment over IFL and IROX for patients
with advanced colorectal cancer.”
The phase-3 clinical study was sponsored by the
National Cancer Institute and conducted by the
North Central Cancer Treatment Group, based at
the Mayo Clinic in Rochester, Minn.
Study Identifies Key Step
Allowing Cells To Migrate
Lineberger researchers discovered a prime regulator
of the mechanism by which human cells migrate in
health and in illness, a process crucial to sustaining
life. Their work helps explain how cells can stick to
a surface long enough to pull themselves and move
forward and then release that grip so that they can
continue and not be anchored to one spot. Under-standing
the complex cascade of molecular events
could become a key to solving the mystery of how
to stop cancer cells in their tracks, like nailing
shoes to the floor.
Cai Huang, a UNC graduate student in cell and
developmental biology, led the study which was
published in the journal Nature. He and colleagues
showed for the first time that an important enzyme
known as JNK, which is involved in many cell
regulatory pathways, also controls a central and
complex step in the biochemical process.
“Cell migration is involved in a variety of normal
and pathological events in life, including embryo
development, wound healing and the abnormal,
life-threatening movement of cancer cells that doc-tors
call metastasis,” explains co-author Ken Jacob-son,
professor of cell and developmental biology
and Lineberger member. “Cai’s work demonstrates
how phosphorylation of a single serine residue of
an important protein component of cell adhesion,
paxillin, can regulate cell migration.”
The study’s other co-authors are Lineberger
member Michael Schaller, professor of cell and de-velopmental
biology; Zenon Rajfur, research assis-tant
professor of cell and developmental biology;
and Christoph Borchers, assistant professor of bio-chemistry
and biophysics and faculty director of
the UNC Proteomics Core Facility.
Study Finds Racial Differences In
Survival Rates After Prostate Cancer
Treatment
A new study shows black men tend to have poorer
overall survival rates than white men after being
treated for localized prostate cancer, with the great-
Profile
Briefs
“Try to enjoy what you’re doing every day you’re
doing it.”
That’s the philosophy Carolyn Sartor brings to
her work as an assistant professor of radiation
oncology at UNC Lineberger. Sartor’s work focuses
on the epidermal growth factor receptor (EGFR)
family and the role these proteins play in breast
cancer development and its response to radio-therapy.
Sartor enjoys the challenge of understanding
ways to treat breast cancers with less treatment.
“It’s fascinating to learn and understand how this
cancer works and try to out-think tumor cells,” she
says. “But day to day, it’s the interaction with the
patients I like the most.”
Less May Be More
She designed and runs a Phase II clinical trial to
investigate the safety and efficacy of the anti-
HER2 antibody, Herceptin, as a radiosensitizing
agent in the treatment of patients with locally
advanced breast cancer. Sartor also is exploring
the efficacy of other EGFR family member
modifiers as radiosensitizers in preclinical models
with the goal of introducing new EGFR family
kinase inhibitors in clinical trials in combination
with radiotherapy.
“We’ve found that some tumor cells are more
sensitive to radiation with Herceptin,” she explains,
“so we’re working with new inhibitors in the lab
Local Angle
Though internationally noted, Sartor’s research has
a lot of value here in the state. “There are a lot of
patients in North Carolina with locally-advanced
disease that is less likely to be controlled with
standard therapy,” she explains.
In 2004, the American Cancer Society esti-mated
6,000 North Carolina women would be
diagnosed with breast cancer and 1,100 will die
from it. “Many women don’t have access to radio-therapy
centers, so a lot of people don’t get appro-priate
therapy,” she explains. Some can’t afford to
travel to the centers, others can’t afford to miss
work.
“If we can come up with safer, better ways to
treat these people with shorter radiation therapy
courses, it could make a huge difference.”•
Carolyn is shown here with Dr. Shelley Earp, Lineberger director, and Nick
Valvano, CEO of the V Foundation. See article on page 8 for additional story on
The V Foundation – a Slam-Dunk for Cancer Research.
Knowing as much as possible about disease, treat-ment
and lifestyle changes is crucial for cancer
patients and those close to them. To augment the
information they receive from their care teams,
many patients turn to the Internet for help. Yet little
is known about which “eHealth” resources they
use, how they use them or whether and how
patients benefit from them.
Patients using the Internet report positive health
effects ranging from decreases in pain and inappro-priate
health care use to improved quality of life
through decreased anxiety and/or depression.
Using Web-based resources also appears to im-prove
patients’ knowledge and increases their con-fidence
in asking questions. This gets them more
involved in their treatment and care.
Caregivers, friends and family also may benefit
from the using the Internet. Online communities
help these people deal with their own depression
and create an opportunity to connect with others
going through similar experiences related to quality
of life, coping with loss, etc.
“Given the immense size of the online health
support community, it’s time to assess its impact
on participants,” says Barbara Rimer, professor of
Health Behavior and Health Education (HBHE)
and deputy director of Population Sciences at the
Lineberger Center.
5
Online Communities
“To assess the impact of ACOR listservs
on chronic disease management for
cancer patients, we are using a multi-method
evaluation based on recom-mended
Internet research pro-cedures,”
she explains.
ACOR is the Association of Cancer
Online Resources, Inc., an Internet-based
clearinghouse for cancer infor-mation.
Its listservs deliver about 1.8
million messages a week to cancer
patients and others.
Rimer’s team consists of partner
Gilles Frydman, founder and president
of ACOR; Michael Bowling, assistant
professor of HBHE; Andrea Meier, research
assistant professor, UNC School of Social Work;
Carol Golin, assistant professor, UNC School of
Medicine and HBHE; Kurt Ribisl, assistant
professor, HBHE; Bernard Glassman, owner, 3am
Communications; Tara Strigo, project manager;
Michael Forlenza, post-doctoral research associate;
and James Rosen, social research assistant, UNC
Lineberger.
Why and How
The Health eCommunities study, which will be
complete in mid-2006, addresses several priority
areas:
Factors influencing use of online interventions
over time
Effects of patient-provider interactions on the
use of eHealth interventions
The benefits and drawbacks of participation in
listservs
The study focuses on nine listservs that func-tion
as electronic support groups (ESGs) for
patients and others (family members, caregivers,
friends, etc.). The primary focus will be on
patients, but data will be collected on “others.”
About 3,360 new patients will be studied, along
with a similarly-sized population of “others.”
“If we learn how quality of life is enhanced for
participants, we can promote that knowledge to
health providers and encourage them to offer
‘Internet prescriptions’— and other referrals — to
the listservs,” Rimer says. “But what if we learn that
there are some downsides of participation, for ex-ample,
that some patients uncritically seek danger-ous
alternative therapies as a result of their partici-pation?
That, too, could be vital knowledge. By the
way, we believe this is unlikely.”
Exemplary Work
The study was one of only 18 projects awarded
$4.8 million in grants by The Robert Wood John-son
Foundation through its Health e-Technologies
Initiative (HeTI). The program seeks to evaluate
and support the use of interactive technologies to
improve health behavior and disease management
“We were particularly interested in this project
because it’s providing a qualitative and quantitative
analysis of the discourse on listservs and the im-pact
of the communication,” said David Ahern,
HeTI’s national program director. “ACOR is an
impressive service, particularly for rare cancers,
providing support, guidance and information. So
an analysis and evaluation of the impact of ACOR
listservs in cancer care is very important.”•
est disparity among men who undergo surgery.
The study’s lead author is Paul Godley, associate
professor of medicine and epidemiology at the
University of North Carolina at Chapel Hill, Line-berger
member and leader of the UNC Program on
Ethnicity, Culture and Health Outcomes. He was
joined by researchers from UNC’s schools of
medicine and public health, Medical Review of
North Carolina and Massachusetts General
Hospital.
The study involved 5,747 black men and
38,242 white men with clinically localized prostate
cancer. Researchers found that among those who
had surgery, the median survival time for black
patients was 1.8 years less than for white patients
(10.8 years versus 12.6 years, respectively). The
differences in median survival times between black
and white patients were smaller among patients
treated with radiation therapy (.7 years) and among
patients who had non-aggressive therapy, also
called “watchful waiting” (1.0 years).
“Figuring out why survival among blacks is worse
and why surgical patients have the largest disparity
will take more research,” Godley says. Several
reasons could account for these disparities. One is
that black patients had reduced access to special-ized
radiation therapy, which is preferred over
surgery for patients in whom locally advanced
cancer is suspected. Another possible explanation
is genetic differences between races in response to
prostate cancer treatment.
cancerLines Spring 2004
continued on page 8
eHealth
Cancer Patients Seek Answers,
Support on theWeb
Carolyn Christoph (Chris)
Johnston Endowment Established
The Carolyn Christoph (Chris) Johnston Endow-ment
for New Ideas in Cancer Research was
established by Charles W. Johnston of Chapel Hill,
NC in February 2004 to target research impacting
ovarian and other women’s cancers. Mr. Johnston
decided that this would be a meaningful way to
honor his late wife’s memory and help find a cure
for cancer with a living, permanent memorial.
Chris Johnston had been a nurse for many years
at UNC Hospitals and died of ovarian cancer in
1994. She had been a patient of Dr. Butch Fowler.
Chris was diagnosed in 1992 and given three weeks
to live, but opted for more aggressive treatment
(taxol) and survived two more years.
If you are interested in contributing to this fund,
please contact Debbie Dibbert at 919-966-5905. Charles Johnston and his late wife Chris.
Odum Lab Dedication
Family and friends joined to dedicate the Jane Lowe Odum Laboratory at UNC
Lineberger Comprehensive Cancer Center on October 13, 2003. Fountain
Odum, a loyal advocate and supporter of the Cancer Center, sponsored a very
successful benefit golf tournament in Charlotte for a number of years to raise
money for UNC Lineberger and to honor the memory of his late wife Jane who
died of pancreatic cancer. Left to right: daughter, Amy Williford; Fountain Odum,
holding grandson William; son, Matthew Odum; and son, David Odum.
6 cancerLines Spring 2004
Lineberger
Zeta Tau Alpha 5K Raises Funds
for Breast Cancer Research
The UNC-Chapel Hill chapter of Zeta Tau Alpha Sorority held its 15th annual
Franklin Street 5K. UNC Lineberger is one of the recipients of funds raised by
the race. Shown here are Dr. Michael O’Malley, associate director of UNC
Lineberger, and Paige Vickory, 5K chair.
NCCU Holds Fifth Annual Walk to Cure
North Carolina Central University held its fifth annual Walk to Cure on
Saturday, January 31. The walk, sponsored by the Iota chapter of Phi Beta
Lambda Inc., has raised over $2,800 for breast cancer research at UNC
Lineberger.
UNC Breast Center Turns 10
November 10-14, 2003 was the 10th birthday of the UNC Breast Center. This
clinic was one of the first to be organized in a multidisciplinary way, and the
successful approach was then used to organize most of the other cancer clinics.
To celebrate the occasion, banners flew on Franklin Street, cake was served
by volunteers in all the clinics and the departments of Surgery and Medicine
held Grand Rounds titled: “The UNC Breast
Center: A Decade of Progress.”
Pictured are speakers and Breast Center
faculty: (left to right) Dr. Mark Graham
(Medical Oncology), UNC Breast Center co-leader,
Cary Oncology; Dr. Carolyn Sartor
(Radiation Oncology), UNC Breast Center co-leader;
Dr. Lisa Carey (Medical Oncology),
UNC Breast Center co-leader; Dr. Nancy
DeMore (Surgical Oncology); Dr. David Ollila
(Surgical Oncology), UNC Breast Center co-leader;
and Dr. Ben Calvo (Surgical Oncol-ogy),
division chief for Surgical Oncology.
McNeills Committed to Cancer Research
Ronald and Cyndi McNeill, members of the UNC Lineberger Board of
Visitors from Wilmington, NC, are strong supporters of the Cancer Center
and its nationally recognized research program. In January, they made a
leadership gift of $100,000 to support cancer research and the develop-ment
of novel therapies. Discovery is our best hope and this is an exciting
time for cancer research. UNC Lineberger researchers are constantly
generating new ideas for preventive, diagnostic, treatment and symptom
management for all types of cancer. The Ronald and Cyndi McNeill Fund
for Cancer Research will have an immediate impact on these efforts to
discover new and more effective treatments to fight and conquer cancer.
cancerLines Spring 2004 7
Scrapbook
Meeting the Marrow Donor
Who Gave David Harrell His Life Back
Cancer patient David Harrell from Ocean Isle Beach, NC, met his transplant
donor Kim Seibert on December 5 when Kim and her husband, Jeff, flew from
Barton City, Michigan, to NC to meet David, his wife, Jeannie and their family,
including daughters Kelley Tucker of Winston Salem and Shelley Roupas of
Fayetteville. Patients may not meet their donors until a year after the transplant.
They all came to UNC Hospitals for a visit and a party to celebrate the suc-cessful
transplant and to thank Kim for being a donor. Left to right: David
Harrell, Kim Seibert, and Dr. Tom Shea, director of the UNC Bone Marrow and
Stem Cell Transplantation Program.
Sisters Network Holds Walk and Health Fair
to Raise Awareness of Breast Cancer
The recently formed Sisters Network, a support and outreach group for North
Carolina African-American breast cancer survivors, held a walk and health fair
for its members and the community on October 25, 2003. Pictured (left to right)
are: Dr. Mark Graham, UNC oncologist; Carolyn Thornton, co-chair of the
“Gift for Life” Walk; Mary Jackson, chair of the “Gift for Life” Walk and UNC
Bone Marrow and Stem Cell Transplantation Program social worker; and Kim
Huck, UNC oncology nurse and coordinator of the Study of Tamoxifen and
Raloxifene (STAR) breast cancer prevention trial.
Proceeds from a bequest from Phillip
Hettleman, Jr., UNC Class of 1976, who died
of cancer in June 2003 have been used to
establish the Hettleman Fund for Cancer
Research at UNC Lineberger Comprehensive
Cancer Center. Mr. Hettleman worked as a
manager for TD Waterhouse and lived in La
Jolla, California. His estate is still being settled
but the bequest is expected to total over
$1,500,000.
While the gift was unrestricted, the pro-ceeds
from Mr. Hettleman’s estate will support
the Center’s efforts to bring fundamental
knowledge regarding cancer and its progres-sion
to the patient in the form of clinical trials
that test novel approaches to therapy.
In his last conversation with Shelley Earp,
Linebeger director, Phil discussed his personal
experience and the paucity of appropriate
clinical trials for his disease. He understood the
regulatory burden and increasing expense of
clinical trials, the teamwork necessary to build
a trials group and the need for a great Uni-versity
faculty to create new avenues for clinical
success.
According to Earp, Phil’s legacy “will have
an enormous impact on our ability to bring
new ideas from the laboratory to the patient
and to test them rigorously through clinical
trials. The Hettleman Fund will help our
faculty test novel cancer therapies and, most
importantly for groundbreaking ideas in
human disease treatment, determine not only
whether they work but why they work or why
they fail.”
The Hettleman family had a long association
with UNC and Phil talked specifically of his
parents’ love for the University. Phil’s parents,
Phillip Hettleman ’21 and Ruth Rea Hettleman,
established the Hettleman Prize, the Hettleman
Chair in Business School, and the Hettleman
Young Faculty Awards. Phil’s father and his
stepbrother, Thomas Hettleman ’56, also died
of cancer. Directing this major legacy from Phil
Hettleman, Jr.’s life work to support clinical
trials and translational cancer research at UNC
seems a most fitting tribute to Phil and his
family.•
Center Receives $1.5 Million
Bequest from PhillipHettleman, Jr.
New Prostate Cancer Surgery
Procedure Offered At UNC
Hospitals
Prostate cancer patients at UNC have a new surgi-cal
option. Rather than undergoing the traditional
radical prostatectomy, they may choose to have the
procedure done laparoscopically, which can reduce
recovery time as well as post-operative pain.
Currently, UNC Hospitals is the only medical cen-ter
in the area offering this procedure.
“Having a prostatectomy done laparoscopically
means less post-operative pain and a shorter recov-ery
time,” said Eric Wallen, assistant professor of
surgery and a Lineberger Center member. “With
the traditional surgery, the recovery period is usual-ly
six to eight weeks, whereas following the laparo-scopic
procedure, the time is reduced to two
weeks. There is also less need for blood transfusion
during surgery.”
For Wallen, another advantage is what he is able
to see. Like the traditional surgery, the new proce-dure
carries a similar risk of incontinence and im-potence.
However, Wallen says, “I have a better
view of the edges of the prostate and the nerves
that are so crucial to the preservation of erections.”
Anyone with a prostate cancer confined only to the
prostate is a candidate for this procedure.
For further information about this procedure or
to make an appointment, please call (919) 966-
9696.•
Briefs
continued from page 4
8 cancerLines Spring 2004
Chemotherapy and Radiation
Combination therapy prior to surgery is now
standard therapy for patients with moderately ad-vanced
tumors still localized to the pelvis. “The
challenge is to make the non-surgical portion of the
therapy even more effective to increase the chance
of preserving the normal anus and sphincter func-tion
as well as decreasing the chance of the tumor
recurring, all while minimizing the side effects from
the therapy,” states Joel Tepper, chair of radiation
oncology at UNC and one of the leaders of the
Multidisciplinary GI Group.
Some rectal tumors are even more advanced in
the pelvis, so that surgery alone is unlikely to pro-duce
a cure. UNC physicians use specialized radia-tion
techniques to give a boost—or extra—dose
of radiation during surgery, where the radiation
would be less likely to damage adjacent normal
tissues but better able to control the tumor. These
intraoperative radiation therapy techniques (IORT)
have proven useful in many situations where con-ventional
therapy is not sufficient to give a good
chance of controlling the disease. UNC Lineberger
is one of the few centers in the U.S. to have dedi-cated
intraoperative radiation therapy.
Molecular Biology Research
Other innovative research involves studying tumor
molecular profiles—called microarrays—that de-tect
the molecular signature of the rectal tumor.
“If we can profile the tumor, we’ll be better able to
give the patient something that works with their
tumor’s characteristics,” Perou notes. Perou is assis-tant
professor of genetics at UNC.“We hope that
this approach will make the treatment more effec-tive,
speeding recovery.”
Combination Therapies
Bert O’Neil, assistant professor of medicine and GI
cancer program member, is leading a team investi-gating
the use of a new kind of drug (Velcade) with
fewer side effects than typical chemotherapy agents
that, when teamed with radiation therapy, will po-tentially
result in a more effective combination treat-ment
without increasing the side effects drama-tically.
“We will be the first center to pair Velcade
with both chemotherapy and radiation in rectal can-cer,”
O’Neil notes. The team is looking at biologic
therapies based on new molecular advances. Com-bined
with radiation therapy, these innovative
chemotherapy agents could prove more effective
than standard treatment. Currently, patient accrual
to a clinical trial using these drugs is just beginning.
As summarized by Dr. Tepper, “our overall goal
is to design therapies directed for the individual
patient which have a better chance of controlling the
tumor while minimizing both the acute and the
long-term side effects. This requires a combination
of understanding the basic biology of the tumor as
well as the best manner in which to individualize the
use of these therapies for each patient.”
For more information about the clinical trials men-tioned
in this story, please call the Protocol Office at
919-966-4432 or toll-free 877-668-0683.•
UNC Lineberger Honors
2003 Oncology Nursing Excellence Award Winners
2003 Oncology Nursing Excellence Award winners were honored at the fall UNC Lineberger Board of Visitors
meeting and at a January 8 reception. Jerome Schiro, who works in the adult outpatient Hematology/Oncology
clinic, won the Charmayne S. Gray Award. The award is named in memory of UNC Lineberger nurse practi-tioner
Charmayne Gray who died in an automobile accident. Michele Busshart, who works in the Hematology/
Oncology medicine unit, won the inpatient award.
The Oncology Nursing Excellence Awards are given in recognition of the nurses’ extraordinary hard work,
care and dedication that they bring to the field each day. Pictured, left to right: Jerome Schiro, Dr. Earp, and
Michele Busshart.
Innovative Research
to Treat Rectal Tumors
continued from page 2
The late legendary basketball coach and ESPN sportscaster
Jim Valvano established The V Foundation for Cancer Re-search
in 1993 to support cancer research and create greater
public awareness of the importance of working to eradicate
cancer.
Working with ESPN, The V Foundation sponsors the
Jimmy V Women’s Basketball Classic, which features the best
women’s college basketball teams in the country and brings
attention to the importance of cancer research.
A portion of the proceeds from the 2003 Jimmy V Classic
held on November 23, 2003, at the RBC Center in Raleigh
was used to fund breast cancer research being conducted by
Dr. Carolyn Sartor, co-leader of the UNC Breast Center. Carolyn accepted her award on national TV at half-time
of the Purdue vs. Duke game.
The V Foundation also has a “V Scholars” program that provides funding for research projects being
conducted by some of the brightest laboratory scientists pursuing basic cancer research. UNC Lineberger is
proud that both Kim Rathmell and Jason Lieb, new young professors at UNC and Lineberger faculty, are
recipients of these two-year, $100,000 V Scholars grants.•
TheV Foundation–
A Slam-Dunk for
Cancer Research
2004 Lineberger
Club Luncheon and
Basketball Game
The 2004 Lineberger Club
lunch and winning basketball
game against UConn was a big
success. The lunch is held in
recognition of Lineberger Club
members who give an annual
gift of at least $1,000 to the
Center.
Sponsors for the event were:
Lee-Moore Oil Company, Stock
Building Supply, Sprint, Cafe
Carolina and Wachovia. Speakers were Dr. Patricia Rivera, assistant professor of
medicine and member of the Multidisciplinary Thoracic Oncology Program
(MTOP), and Katherine Wilson, a UNC Nursing School student from Morgan-ton,
NC, and lung cancer patient.
Katherine is shown in the top photo with her family (front, left to right): mother,
Anne Wilson; Katherine; boyfriend Brian Wood; (standing, left to right): brother,
Fletcher; father, John; and brother, J.D.
Lower left photo (left to right): Lineberger Board member John Burress of
Winston-Salem auctioned off the basketball signed by the UNC men’s team and
coaches. The winners were Flo and Charles Winston of Raleigh.
cancerLines Spring 2004 9
Scrapbook
Sibling Donates Marrow to Two Other Brothers;
Donor: ‘It has a been a blessing for my family’
Mike Bednar of Pittsboro, NC, and his brother Martial of Rochester, NY, share
more than the family name. They share an immune system, thanks to Martial’s
donation to Mike, who needed a transplant to treat his multiple myeloma.
When Martial’s marrow type proved a perfect match for Mike, it would be the
second time for Martial and what is believed to be the first time in the United
States that an adult donor had given marrow to two siblings.*
In 1996, Martial first donated his marrow to his brother Merrick, a Roman
Catholic priest who had a lengthy and complicated medical history of cancer
and heart disease and who died awaiting a second heart transplant.
In summer 2003, Martial donated his marrow again, this time to his eldest
brother, Mike, who received it in November as part of a clinical trial sponsored by
Cancer and Leukemia Group B (CALGB) through the Lineberger Protocol Office.
Dr. Don Gabriel, professor of medicine in UNC’s School of Medicine and
member of the Lineberger Center, is Mike Bednar’s physician.“When you’re
facing a deadly disease as Mike Bednar is, hope is inexorably linked to an
available donor. Mike is fortunate that his brother was a perfect match. But not
everyone has a brother who is a perfect match.
“Being a donor takes time out of your life; it’s not something you have to do.
Donors are heroes as well as the recipient and the families. Martial Bednar’s
experience as a donor shows that it’s not dangerous. He’s done it twice!
“We hope that people will consider getting registered with the National
Registry. They can save someone’s life. The more potential donors we have in
the registry, the greater the chance that a match can be found for a patient.”
*The United Network for Organ Sharing, the University of California at Los Angeles Immuno-genetics
Center and the Fred Hutchinson Cancer Research Center revealed no other known instances
of a donor giving marrow to two different siblings. The International Bone Marrow Transplant
Registry was contacted, but does not track such data.
Great Human Race
UNC Lineberger was the only UNC group
participating in the Great Human Race, a
fundraising event organized by the Volunteer
Center of Durham held on Saturday, March 27 at
the Durham Bulls Athletic Park.
The 16-member team of walkers raised close
to $2,000 for cancer research at UNC
Lineberger. Pictured getting warmed up for the
walk are (left to right): Michelle Johnson, Mia
Jones, Megan Crow, Lisa Miser. and Amy
Mansfield.
10 cancerLines Spring 2004
caolfe nedvaernts
A p r i l 2 4
UNC Lineberger Beach Ball. University Mall,
Chapel Hill, NC. For more information:
http://unclineberger.org
J u n e 1 2
NC Triangle Susan G. Komen Breast Cancer
Foundation Race for the Cure. Raleigh, NC.
S e p t e m b e r 1 8
Leukemia & Lymphoma Society Light the
Night. Raleigh, NC.
S e p t e m b e r 2 1
Gynecologic Cancer Awareness Luncheon.
Cary, NC.
S e p t e m b e r 2 4
Board of Visitors. Lineberger Cancer Center,
Chapel Hill, NC.
O c t o b e r 7
Pretty ’n Pink Women’s Cancers Luncheon.
Squid’s Restaurant, Chapel Hill, NC.
UNC Lineberger Comprehensive Cancer Center
CB# 7295
School of Medicine
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599-7295
(919) 966-3036
http://unclineberger.org
Return Forwarding, and Return Postage Guaranteed.
Address Correction Requested.
Nonprofit Organization
U.S. Postage
PAID
Permit No. 71
Chapel Hill, NC 27599-1110
New NC Cancer Hospital Plans Continue
Architects have
continued planning
for the proposed
new NC Cancer
Hospital pending
authorization by the
NC General Assem-bly.
Funding for the
over 300,000
square foot hospital
will be considered
by legislators during
the upcoming short
session beginning
in May 2004.
Over 50 groups
have been meeting
with the architects
to plan a facility that will make UNC Lineberger and its clinical program among the most advanced in
the nation. It has been exciting for these multiple groups—patients, oncology nurses, physicians,
support personnel and other staff—to participate in this planning process. The building will face a new
green space developed once the existing Gravely Building is torn down. The new building will connect
through the lobby spaces for NC Women’s, Children’s, Neurosciences and NC Memorial Hospitals.
A clinical cancer office building will be constructed directly across Manning Drive.•
The United States Department of
Defense Prostate Cancer Research
Program has awarded a $9.9 million
grant to a new consortium of top U.S.
cancer researchers trying to discover
why prostate cancer deaths are more
than twice as common in black men
as in white men and why such deaths
also vary significantly from state to
state. Dr. James Mohler of UNC
Lineberger and Roswell Park Cancer
Institute will serve as consortium
director of the three-year study. This
project and others examining prostate
cancer will be featured in the fall issue
of Cancer Lines.
Grant Awarded
for New Cancer
Research
MANNING DRIVE
EXISTING UNC HOSPITALS

LU N C L i n ecb e r g e ria C o mnpnr e h e n seicv e C aesn c e r Cre n t e r The Cancer Program of UNC-Chapel Hill & UNC Health Care Spring 2004
Putting Out
Youth Tobacco Use
Reducing and preventing
tobacco use is a touchy sub-ject
for North Carolinians.
Long before becoming famous
for superior collegiate basket-ball,
North Carolina was
known simply as Tobacco
Road.
Cigarette smoking is the
nation’s leading cause of pre-mature
sickness and death,
accounting for over 400,000
deaths each year. More than
47 million adults and 4 mil-lion
teenagers smoke.
The use of tobacco is par-ticularly
troubling among young people. Research from the
Centers for Disease Control and Prevention found that every
day more than 4,000 Americans between the ages of 12 and
17 try their first cigarettes. And while smoking is declining
among all other age groups, it remains high among 18 to 24
year olds, rising 23 percent between 1991 and 2001.
Researchers at UNC Lineberger are helping to combat
these rising statistics. Here’s a look at some of the tobacco-related
projects under way.
Influencing Childhood Decisions:
Stopping Youth Smoking Before It Starts
Evidence from an eight-year study by Christine Jackson,
associate professor of health behavior and health education,
showed that the more cigarettes a child smoked at an early
the inside line up ...
5Answers &
Support on
the Web
2Director’s
Message
age, the more likely they were to be a daily smoker as a teen.
The study included 737 children from central North Caro-lina.
Their cigarette use was measured at ages 8 and 10 and
again at age 17.
“This study was the first to examine whether cigarette use
in early childhood was associated with all levels of smoking
in adolescence or with nicotine-dependent (daily) use speci-fically,”
Jackson explains. The study investigated what level
of cigarette use in childhood increased the odds of smoking
in adolescence.
Among those who did not smoke any cigarettes in early
childhood, 10 percent became daily smokers by age 17,
whereas 39 percent of those who smoked more than 20 ciga-
4Profile: Sartor
& Briefs
eHealth
10New NC Cancer
Hospital Plans &
Calendar of
Events
continued on page 3
6Lineberger
Scrapbook
Researchers Breathe Life into
Anti-Tobacco Initiatives forYoung People
Kurt Ribisl and UNC Tobacco Use and Prevention and Control Training Project
members look over tobacco products obtained by underage youth over the Inter-net.
Pictured above left to right: Kurt Ribisl, Rebecca Williams, Annice Kim,
and Sarah Pearcy.
35.8% currently use some tobacco product
27.8% currently smoke cigarettes
47.5% live in homes where someone smokes
73.4% were in the same room with someone who was smoking
on one or more days in the week that preceded the survey
NC High School Students Tobacco Use NC Middle School Students Tobacco Use
17.4% currently use some tobacco product
11.3% currently smoke cigarettes
47.1% live in homes where someone smokes
55.5% were in the same room with someone who was smoking
on one or more days in the week that preceded the survey
Source: 2001 NC Youth Tobacco Survey
creased 35 percent in the last six
years, and as the population of our
state grows and grays, those numbers
will rise significantly.
The New Hospital:
How would it benefit North Carolina
citizens?
• more room for a growing patient
population
• specially designed facilities for high-technology
tumor imaging, genetic analysis, and novel
treatments
• incorporating amenities and support services
for all patients.
• enhanced clinical research and innovative care
options
• teleconferencing facilities to include community-based
physicians in treatment planning for their
patients, allowing most treatments to be continued
in their home communities.
• pairing cancer care with a preventive clinic
focused on surviving patients and their families as
well as high-risk individuals and their families
A new NC Cancer Hospital will harness the
power of genetics and technology, the
foundation of the future individualized cancer
care. In the hands of skilled and compas-sionate
physicians, these developments will
drive both the standard of care and the clinical
research agenda at world-class institutions.
The NC Cancer Hospital, complete with a
nationally recognized clinical and prevention
research agenda, will bring this to all citizens of
North Carolina.
Leadership Change at UNC Heath Care
Ending on a personal note I will certainly miss
working with Jeff Houpt, my Dean and Health
System CEO for the last seven years. Jeff’s
legacy of facility improvements is all around us
and his outstanding leadership appointments
have helped build a world class cancer center.
At the same time I am very pleased with the
appointment of Bill Roper as Jeff’s replace-ment.
In the past, Dr. Roper headed both the
nation’s Medicare program and Centers for
Disease Control and Prevention in Atlanta. For
the last seven years he was a great Lineberger
friend in his role as Dean of the UNC School
of Public Health. He is determined to expand
on Jeff Houpt’s legacy, bringing the best in
prevention, early detection and health care to
North Carolina.•
2 cancerLines Spring 2004
UNC Lineberger is designated a
comprehensive cancer center by the
National Cancer Institute.
Cancer Lines is a semi-annual
publication of the UNC Lineberger
Comprehensive Cancer Center,
The University of North Carolina
School of Medicine at Chapel Hill.
Dr. H. Shelton Earp, III, Director
Dr. Joseph S.Pagano, Director Emeritus
Debbie Dibbert, Director of
External Affairs
Dianne G. Shaw, Director of
Communications/Executive Editor
Margot Carmichael Lester, Editor
Please remove me from your
mailing list
Name
Please add the following to the
Cancer Center’s mailing list.
Name
Address
City, State, Zip
UNC Lineberger
Comprehensive Cancer Center
CB# 7295
School of Medicine
University of North Carolina at
Chapel Hill
Chapel Hill, NC 27599-7295
(919) 966-3036
http://unclineberger.org
Printed on Recycled Paper
MeDsisreactgor’es
Every five years, the
National Cancer In-stitute
evaluates the
progress of each
comprehensive can-cer
center and ad-justs
the federal bud-get
supporting the
Center’s research
and infrastructure.
This so-called NCI
core funding is one
of the largest grants
at UNC Chapel Hill,
and the process, sim-ply
because of its importance, is a “nail biter.”
To prepare for this five-year review we initiated a
strategic planning process.
During the last twelve months our program
leaders involved virtually all 235 Cancer Center
members in a stimulating exercise to plot the
course of cancer discovery at UNC. First, we
challenged the faculty to think broadly about
what discoveries and strategic directions are
likely to make an impact on cancer over the
next five to ten years. Next, we considered
what we at UNC do best and how we could
apply our strengths to the faculty’s prediction
of pivotal and strategic directions. Lastly, we
asked ourselves whether there are some areas
that are just so important that we need to
build, if necessary from scratch, to supplement
our current strengths.
What makes our Cancer Center and this
planning process so unique is the tremendous
breadth of our membership; they represent so
many disciplines across societal and biomedi-cal
research. If you were to tour the UNC cam-pus
to find Cancer Center members, you would
start near the arboretum at the Department of
Psychology, turn left at the Old Well to walk
through Polk Place with the School of Infor-mation
and Library Science on your left and
the Schools of Journalism and Computer
Science on your right. Then you would wind
up Columbia Street past Chemistry, Biology,
the Schools of Pharmacy, Nursing, and Public
Health, before turning on Manning Drive past
the home of one of the greatest medical
sciences faculties in the country, and end up
at the door of our clinical facilities at UNC
Hospitals.
It is our goal to combine all these strengths
and be a major contributor in the national and
international fight against cancer. The first step
was our completed 10-page strategic plan; re-sulting
from the above process; the second
step, an NCI grant request, extolling our vir-tues
and laying out an increased budget in a
“succinct” 1,700 page document, weighing 36
pounds, and measuring 701 cubic inches. On
May 26, some of the nation’s best scientists will
come to Chapel Hill to assess our strategy for
the next five years. We are confident that we
have right stuff, and we will let you how we do.
The New NC Cancer Hospital:
A Growing Need
Speaking of those clinical facilities, the num-ber
of cancer patients coming to UNC Line-berger
seeking treatment is increasing dra-matically.
We appreciate their confidence and
trust in our physicians, nurses and our multi-disciplinary
approach. They love the care that
they receive, but not the facilities in which it is
delivered.
Many of the advances in cancer diagnostics
and therapy you learn about from the media
are available at UNC, but it’s difficult to pro-vide
leading-edge technology and therapies in
a clinical center occupying a vintage 1950’s
tuberculosis sanatorium facility. We have reno-vated
as much as we can to make the space
safe and functional for our staff and patients,
but we’re out of room. We need a new facility!
As the public cancer center for the people
and state of North Carolina, we hold ourselves
to a high standard of care; achieving this goal
is increasingly difficult in our antiquated build-ing.
Our cancer patient numbers have in-
Dr. H. Shelton Earp, III
About 40,000 people develop rectal cancer in the
United States every year; however, rectal cancer
therapy is currently less than ideal, concedes Ben
Calvo, chief of the division of surgical oncology and
GI cancer program leader for UNC Lineberger.
Although substantial progress has been made,
about 40 percent of patients with rectal cancer will
eventually die of their disease, and many more will
have substantial side effects from the therapy.
In the past, most patients with rectal tumors
close to the anus required an abdominal perineal
resection, where both the rectum and anus were
resected and resulted in patients having a perma-nent
colostomy. Treatment with a combination of
radiation and chemotherapy prior to surgery can
reduce tumor size in about 30 percent of patients
and more frequently allows for operations where
the anus is preserved, thus obviating the need for
a colostomy—surgery to form an artificial anal
opening in the body from the colon.
The UNC Lineberger multidisciplinary GI cancer
team includes medical oncologists (Richard Gold-berg,
Steve Bernard, Bert O’Neil), surgeons (Ben
Calvo, H.J. Kim, Michael Meyers), radiation oncol-
UNC Lineberger Multi-disciplinary
GI Team
Use Innovative Research
to Treat Rectal Tumors
ogists ( Joel Tepper, Lav Goyal), and laboratory
scientists (Chuck Perou, Al Baldwin). One of the
main research objectives for this team is to increase
the percentage of tumors that will shrink with com-bination
chemo and radiation treatment. This
would improve the chances of rectal preservation
as well as maintaining the function of surrounding
organs such as the bladder and sexual function.
UNC Lineberger
GI cancer experts
discuss the
protocol. Left to
right: Drs. Joel
Tepper, Bert
O’Neil, Ben
Calvo, H.J. Kim
and Michael
Meyers.
continued on page 8
rettes as young children became daily smokers.
“This study provides important prospective evi-dence
that relatively small increases in the number
of cigarettes smoked during childhood are associ-ated
with substantial increases in the proportion of
youth reporting smoking at late adolescence,” she
says. The study is also characterizing the relations
between parental smoking habits and early
childhood smoking.
Surfing for Smokes
Another concern: kids’ access to cigarettes on the
Internet. Weak or nonexistent age verification
methods make it easy for youngsters to make illegal
purchases. Kurt Ribisl was the first researcher to
scientifically investigate Internet cigarette sales to
minors. Ribisl is assistant professor of health
behavior and health education in the School of
Public Health and program director for the UNC
Pre-doctoral Tobacco Use Prevention and Control
Training Program.
His study employed four children aged 11 to 15
whose activities were supervised by adults. “The
kids made 83 purchase attempts, paying by credit
card 47 times and by money order 36 times,”
Ribisl explains. “The Internet vendors sent a total
of 1,650 packs of cigarettes to these underage
youth—and age was never verified for any of
them.”
So why not shut down these vendors? Simple,
Ribisl says. “There’s no federal law that bans Inter-net
and mail order cigarette sales to minors and
only six states prohibit it. Thus, none of the Web
sites in this study was breaking any federal laws by
selling to children.
��Our study clearly shows that Internet cigarette
vendors are not adequately verifying the age of
their customers and that federal action is urgently
needed. Pornography sites probably do a better
job of verifying the ages of their customers than
Web sites selling cigarettes.”
Youth Empowerment
Programs
Smoke-free environments are crucial to reducing
and preventing tobacco use among teens. That’s the
principle behind the Tobacco-Free Schools (TFS)
initiative. According to the Centers for Disease Con-trol
and Prevention, a TFS “bans all tobacco use by
students, all school staff, and visitors on school
property, in school vehicles, and at school functions
away from school property.”
Kurt Ribisl is involved in this effort as well.
“Studies have shown that school smoking restric-tions
are worth pursuing. The student smoking rates
at schools that have and enforce smoking restric-tions
are 11 percent lower than at schools without
smoking restrictions,” says Ribisl, principal invest-igator
for the NC Youth Empowerment Study (NC
YES), a research project designed to evaluate youth-led,
adult-supported programs that create effective
policies and activities to reduce tobacco use.
Unfortunately, only 16 percent of NC school
districts are smoke-free, says Ribisl. To improve that
number, NC YES examined how 15 districts
secured passage of 100 percent tobacco-free school
policies. Those tactics will be shared with other
schools in an effort in improve their efforts at
passage.
Anti-Tobacco Initiatives
continued from page 1
cancerLines Spring 2004 3
Activist shares life story,
anti-tobacco message with kids
Gary Miner, a cigarette smoker of over 35
years, developed throat cancer in 1999. But
even after his initial diagnosis and a grim
forecast, Miner continued the habit—or
addiction, as he likes to call it.
It wasn’t until he entered UNC Hospitals
for his laryngectomy in
2000 that Miner decided
he needed to change. He
smoked a pack of cig-arettes
before leaving for
the surgery, but once he
set foot into the facility,
his attitude changed.
Miner’s surgery re-moved
his voice box and
half of his throat, taking
away his ability to talk
without the aid of an
electronic voice box, as
well as his senses of taste and smell.
The combined impact of these physical
changes compelled him to become an advo-cate
for tobacco use prevention.
“I had a drive that just kept on eating at
me,” Miner said. “I knew one day I’d leave
work and speak to every kid and talk to them
about the hazards of tobacco.”
Miner left his job as director for the
Marine Corps’ East Coast Regional Devel-opment
Center and pursued his new career.
He traveled throughout the state with his
wife, Janet, promoting his own tobacco
cessation program.
“The school kids told me I had a great mes-sage,
but needed to do something about it,”
Miner said. “During our talk, they said we
should have started the program yesterday.”
As a result, he founded Students Teaching
Resistance Information 2 Kids Everywhere
(Strike2) for students in Onslow County.
Now in its third year, Strike2 has trained
46 high school students and hopes to expand
to all eight Onslow County high schools. Stu-dents
at each high school educate children in
middle and elemen-tary
schools and
produce programs
to spread the word.
When he can,
Miner attends the
educational ses-sions.
To drive his
point home, he
struggles for breath
as he presses a
rubber valve in his
throat to activate his
voice box, which produces a startling sound.
The kids are always speechless.
Strike2 is having an impact. The group
created an anti-tobacco public service
announcement that began airing on
Jacksonville-area television stations in March
and convinced the Onslow County board of
education to declare its district smoke-free.
With the program in full swing, Miner is
spreading his influence to a wider audience.
He and Janet are back on the road, traveling
throughout North America to reach more
young people with his message. Last year,
they visited schools in 32 states and Canada.
Miner sees his experience with throat
cancer as an opportunity to keep others from
similar outcomes.
“All we’re trying to do is deliver a message
that tobacco can and will harm your body,”
Miner says.“Why take the chance?”
Gary and Janet Miner
Tackling Smoking
Smoking at high school athletic events is also tar-geted
via the Tackle Smoking Project. This project,
led by Eric Pevzner, a doctoral student in health
behavior and health education in the School of
Public Health, examines TFS compliance at foot-ball
games. On average, observers recorded far
fewer instances of smoking at games at TFS schools
than they did at non-TFS schools. The lower rate is
attributed in part to no-smoking signs and public
announcements in stadiums to inform spectators
of the policy.
Pevzner has expanded the study to determine if
supplemental signage, public announcements and
warnings by security staff will decrease the amount
of smoking and exposure to secondhand smoke at
high school football games.•
UNC Lineberger has changed its web address
Our new address is
www.unclineberger.org.
The old address
(http://cancer.med.unc.edu)
still works, but we thought
the new address
might be easier to remember.
and in trials with patients who have the
most aggressive breast cancers, despite
having full surgical, chemo and radiation
treatments.”
Navigating Medicine
The daughter of a systems analyst/home-maker
and an engineer, Sartor says,
“Medicine was always held up to be an
honorable profession. That reputation
pulled me in more than anything.”
Though always interested in medicine
as a career, Sartor didn’t originally pursue
oncology.“I was intrigued by neurosurgery, mostly
because I’d never met or seen a neurosurgeon,” she
admits.
She studied biomedical sciences in college at
the University of Michigan and decided on oncol-ogy
there. That’s also where she met her husband,
Nick, during college orientation.
“We were hating the winters,” she recalls. “We
went to a movie with a leader about North Caro-lina.”
Two things about the state were hard to resist:
“the phenomenal experts in my area like Ed Liu,
Bev Mitchell and Shelley Earp; and great sailing.”
An avid sailor, Sartor has three boats and sails
whenever possible. She and her husband spent a
year sailing the inland waterway from Michigan to
Florida. Her ideal trip: “Sailing the coast of Spain.
But I also love the Intracoastal Waterway.”
4 cancerLines Spring 2004
Combination Treatment Helps
Patients With Advanced Colorectal
Cancer
Results of a five-year study of 795 advanced colo-rectal
cancer patients show that a new combination
of chemotherapy drugs, known as FOLFOX 4, out-performs
the standard chemotherapy treatment.
Patients receiving the new combination lived an
average of 19.5 months after beginning treatment,
the study found, compared to 14.8 months for
patients receiving the standard IFL treatment.
FOLFOX 4 patients also had fewer serious side
effects such as infections, diarrhea and vomiting
and severe hair loss.
FOLFOX 4 is a chemotherapy regimen in-cluding
the recently approved drug oxaliplatin
(Eloxatin) combined with 5-Fluorouracil. IFL is a
treatment which uses the chemotherapy drugs
irinotecan (Camptosar, CPT-11) with 5-FU and
leucovorin.
“This is the greatest increase in survival time re-corded
to date with a new treatment used by
patients enrolled in a large
randomized study of colo-rectal
cancer in the United
States,” says Richard Gold-berg,
the study’s lead re-searcher,
and the Lineberger
Center’s associate director.
“Based on these findings, we conclude that the
FOLFOX 4 treatment should be considered as a
first-line treatment over IFL and IROX for patients
with advanced colorectal cancer.”
The phase-3 clinical study was sponsored by the
National Cancer Institute and conducted by the
North Central Cancer Treatment Group, based at
the Mayo Clinic in Rochester, Minn.
Study Identifies Key Step
Allowing Cells To Migrate
Lineberger researchers discovered a prime regulator
of the mechanism by which human cells migrate in
health and in illness, a process crucial to sustaining
life. Their work helps explain how cells can stick to
a surface long enough to pull themselves and move
forward and then release that grip so that they can
continue and not be anchored to one spot. Under-standing
the complex cascade of molecular events
could become a key to solving the mystery of how
to stop cancer cells in their tracks, like nailing
shoes to the floor.
Cai Huang, a UNC graduate student in cell and
developmental biology, led the study which was
published in the journal Nature. He and colleagues
showed for the first time that an important enzyme
known as JNK, which is involved in many cell
regulatory pathways, also controls a central and
complex step in the biochemical process.
“Cell migration is involved in a variety of normal
and pathological events in life, including embryo
development, wound healing and the abnormal,
life-threatening movement of cancer cells that doc-tors
call metastasis,” explains co-author Ken Jacob-son,
professor of cell and developmental biology
and Lineberger member. “Cai’s work demonstrates
how phosphorylation of a single serine residue of
an important protein component of cell adhesion,
paxillin, can regulate cell migration.”
The study’s other co-authors are Lineberger
member Michael Schaller, professor of cell and de-velopmental
biology; Zenon Rajfur, research assis-tant
professor of cell and developmental biology;
and Christoph Borchers, assistant professor of bio-chemistry
and biophysics and faculty director of
the UNC Proteomics Core Facility.
Study Finds Racial Differences In
Survival Rates After Prostate Cancer
Treatment
A new study shows black men tend to have poorer
overall survival rates than white men after being
treated for localized prostate cancer, with the great-
Profile
Briefs
“Try to enjoy what you’re doing every day you’re
doing it.”
That’s the philosophy Carolyn Sartor brings to
her work as an assistant professor of radiation
oncology at UNC Lineberger. Sartor’s work focuses
on the epidermal growth factor receptor (EGFR)
family and the role these proteins play in breast
cancer development and its response to radio-therapy.
Sartor enjoys the challenge of understanding
ways to treat breast cancers with less treatment.
“It’s fascinating to learn and understand how this
cancer works and try to out-think tumor cells,” she
says. “But day to day, it’s the interaction with the
patients I like the most.”
Less May Be More
She designed and runs a Phase II clinical trial to
investigate the safety and efficacy of the anti-
HER2 antibody, Herceptin, as a radiosensitizing
agent in the treatment of patients with locally
advanced breast cancer. Sartor also is exploring
the efficacy of other EGFR family member
modifiers as radiosensitizers in preclinical models
with the goal of introducing new EGFR family
kinase inhibitors in clinical trials in combination
with radiotherapy.
“We’ve found that some tumor cells are more
sensitive to radiation with Herceptin,” she explains,
“so we’re working with new inhibitors in the lab
Local Angle
Though internationally noted, Sartor’s research has
a lot of value here in the state. “There are a lot of
patients in North Carolina with locally-advanced
disease that is less likely to be controlled with
standard therapy,” she explains.
In 2004, the American Cancer Society esti-mated
6,000 North Carolina women would be
diagnosed with breast cancer and 1,100 will die
from it. “Many women don’t have access to radio-therapy
centers, so a lot of people don’t get appro-priate
therapy,” she explains. Some can’t afford to
travel to the centers, others can’t afford to miss
work.
“If we can come up with safer, better ways to
treat these people with shorter radiation therapy
courses, it could make a huge difference.”•
Carolyn is shown here with Dr. Shelley Earp, Lineberger director, and Nick
Valvano, CEO of the V Foundation. See article on page 8 for additional story on
The V Foundation – a Slam-Dunk for Cancer Research.
Knowing as much as possible about disease, treat-ment
and lifestyle changes is crucial for cancer
patients and those close to them. To augment the
information they receive from their care teams,
many patients turn to the Internet for help. Yet little
is known about which “eHealth” resources they
use, how they use them or whether and how
patients benefit from them.
Patients using the Internet report positive health
effects ranging from decreases in pain and inappro-priate
health care use to improved quality of life
through decreased anxiety and/or depression.
Using Web-based resources also appears to im-prove
patients’ knowledge and increases their con-fidence
in asking questions. This gets them more
involved in their treatment and care.
Caregivers, friends and family also may benefit
from the using the Internet. Online communities
help these people deal with their own depression
and create an opportunity to connect with others
going through similar experiences related to quality
of life, coping with loss, etc.
“Given the immense size of the online health
support community, it’s time to assess its impact
on participants,” says Barbara Rimer, professor of
Health Behavior and Health Education (HBHE)
and deputy director of Population Sciences at the
Lineberger Center.
5
Online Communities
“To assess the impact of ACOR listservs
on chronic disease management for
cancer patients, we are using a multi-method
evaluation based on recom-mended
Internet research pro-cedures,”
she explains.
ACOR is the Association of Cancer
Online Resources, Inc., an Internet-based
clearinghouse for cancer infor-mation.
Its listservs deliver about 1.8
million messages a week to cancer
patients and others.
Rimer’s team consists of partner
Gilles Frydman, founder and president
of ACOR; Michael Bowling, assistant
professor of HBHE; Andrea Meier, research
assistant professor, UNC School of Social Work;
Carol Golin, assistant professor, UNC School of
Medicine and HBHE; Kurt Ribisl, assistant
professor, HBHE; Bernard Glassman, owner, 3am
Communications; Tara Strigo, project manager;
Michael Forlenza, post-doctoral research associate;
and James Rosen, social research assistant, UNC
Lineberger.
Why and How
The Health eCommunities study, which will be
complete in mid-2006, addresses several priority
areas:
Factors influencing use of online interventions
over time
Effects of patient-provider interactions on the
use of eHealth interventions
The benefits and drawbacks of participation in
listservs
The study focuses on nine listservs that func-tion
as electronic support groups (ESGs) for
patients and others (family members, caregivers,
friends, etc.). The primary focus will be on
patients, but data will be collected on “others.”
About 3,360 new patients will be studied, along
with a similarly-sized population of “others.”
“If we learn how quality of life is enhanced for
participants, we can promote that knowledge to
health providers and encourage them to offer
‘Internet prescriptions’— and other referrals — to
the listservs,” Rimer says. “But what if we learn that
there are some downsides of participation, for ex-ample,
that some patients uncritically seek danger-ous
alternative therapies as a result of their partici-pation?
That, too, could be vital knowledge. By the
way, we believe this is unlikely.”
Exemplary Work
The study was one of only 18 projects awarded
$4.8 million in grants by The Robert Wood John-son
Foundation through its Health e-Technologies
Initiative (HeTI). The program seeks to evaluate
and support the use of interactive technologies to
improve health behavior and disease management
“We were particularly interested in this project
because it’s providing a qualitative and quantitative
analysis of the discourse on listservs and the im-pact
of the communication,” said David Ahern,
HeTI’s national program director. “ACOR is an
impressive service, particularly for rare cancers,
providing support, guidance and information. So
an analysis and evaluation of the impact of ACOR
listservs in cancer care is very important.”•
est disparity among men who undergo surgery.
The study’s lead author is Paul Godley, associate
professor of medicine and epidemiology at the
University of North Carolina at Chapel Hill, Line-berger
member and leader of the UNC Program on
Ethnicity, Culture and Health Outcomes. He was
joined by researchers from UNC’s schools of
medicine and public health, Medical Review of
North Carolina and Massachusetts General
Hospital.
The study involved 5,747 black men and
38,242 white men with clinically localized prostate
cancer. Researchers found that among those who
had surgery, the median survival time for black
patients was 1.8 years less than for white patients
(10.8 years versus 12.6 years, respectively). The
differences in median survival times between black
and white patients were smaller among patients
treated with radiation therapy (.7 years) and among
patients who had non-aggressive therapy, also
called “watchful waiting” (1.0 years).
“Figuring out why survival among blacks is worse
and why surgical patients have the largest disparity
will take more research,” Godley says. Several
reasons could account for these disparities. One is
that black patients had reduced access to special-ized
radiation therapy, which is preferred over
surgery for patients in whom locally advanced
cancer is suspected. Another possible explanation
is genetic differences between races in response to
prostate cancer treatment.
cancerLines Spring 2004
continued on page 8
eHealth
Cancer Patients Seek Answers,
Support on theWeb
Carolyn Christoph (Chris)
Johnston Endowment Established
The Carolyn Christoph (Chris) Johnston Endow-ment
for New Ideas in Cancer Research was
established by Charles W. Johnston of Chapel Hill,
NC in February 2004 to target research impacting
ovarian and other women’s cancers. Mr. Johnston
decided that this would be a meaningful way to
honor his late wife’s memory and help find a cure
for cancer with a living, permanent memorial.
Chris Johnston had been a nurse for many years
at UNC Hospitals and died of ovarian cancer in
1994. She had been a patient of Dr. Butch Fowler.
Chris was diagnosed in 1992 and given three weeks
to live, but opted for more aggressive treatment
(taxol) and survived two more years.
If you are interested in contributing to this fund,
please contact Debbie Dibbert at 919-966-5905. Charles Johnston and his late wife Chris.
Odum Lab Dedication
Family and friends joined to dedicate the Jane Lowe Odum Laboratory at UNC
Lineberger Comprehensive Cancer Center on October 13, 2003. Fountain
Odum, a loyal advocate and supporter of the Cancer Center, sponsored a very
successful benefit golf tournament in Charlotte for a number of years to raise
money for UNC Lineberger and to honor the memory of his late wife Jane who
died of pancreatic cancer. Left to right: daughter, Amy Williford; Fountain Odum,
holding grandson William; son, Matthew Odum; and son, David Odum.
6 cancerLines Spring 2004
Lineberger
Zeta Tau Alpha 5K Raises Funds
for Breast Cancer Research
The UNC-Chapel Hill chapter of Zeta Tau Alpha Sorority held its 15th annual
Franklin Street 5K. UNC Lineberger is one of the recipients of funds raised by
the race. Shown here are Dr. Michael O’Malley, associate director of UNC
Lineberger, and Paige Vickory, 5K chair.
NCCU Holds Fifth Annual Walk to Cure
North Carolina Central University held its fifth annual Walk to Cure on
Saturday, January 31. The walk, sponsored by the Iota chapter of Phi Beta
Lambda Inc., has raised over $2,800 for breast cancer research at UNC
Lineberger.
UNC Breast Center Turns 10
November 10-14, 2003 was the 10th birthday of the UNC Breast Center. This
clinic was one of the first to be organized in a multidisciplinary way, and the
successful approach was then used to organize most of the other cancer clinics.
To celebrate the occasion, banners flew on Franklin Street, cake was served
by volunteers in all the clinics and the departments of Surgery and Medicine
held Grand Rounds titled: “The UNC Breast
Center: A Decade of Progress.”
Pictured are speakers and Breast Center
faculty: (left to right) Dr. Mark Graham
(Medical Oncology), UNC Breast Center co-leader,
Cary Oncology; Dr. Carolyn Sartor
(Radiation Oncology), UNC Breast Center co-leader;
Dr. Lisa Carey (Medical Oncology),
UNC Breast Center co-leader; Dr. Nancy
DeMore (Surgical Oncology); Dr. David Ollila
(Surgical Oncology), UNC Breast Center co-leader;
and Dr. Ben Calvo (Surgical Oncol-ogy),
division chief for Surgical Oncology.
McNeills Committed to Cancer Research
Ronald and Cyndi McNeill, members of the UNC Lineberger Board of
Visitors from Wilmington, NC, are strong supporters of the Cancer Center
and its nationally recognized research program. In January, they made a
leadership gift of $100,000 to support cancer research and the develop-ment
of novel therapies. Discovery is our best hope and this is an exciting
time for cancer research. UNC Lineberger researchers are constantly
generating new ideas for preventive, diagnostic, treatment and symptom
management for all types of cancer. The Ronald and Cyndi McNeill Fund
for Cancer Research will have an immediate impact on these efforts to
discover new and more effective treatments to fight and conquer cancer.
cancerLines Spring 2004 7
Scrapbook
Meeting the Marrow Donor
Who Gave David Harrell His Life Back
Cancer patient David Harrell from Ocean Isle Beach, NC, met his transplant
donor Kim Seibert on December 5 when Kim and her husband, Jeff, flew from
Barton City, Michigan, to NC to meet David, his wife, Jeannie and their family,
including daughters Kelley Tucker of Winston Salem and Shelley Roupas of
Fayetteville. Patients may not meet their donors until a year after the transplant.
They all came to UNC Hospitals for a visit and a party to celebrate the suc-cessful
transplant and to thank Kim for being a donor. Left to right: David
Harrell, Kim Seibert, and Dr. Tom Shea, director of the UNC Bone Marrow and
Stem Cell Transplantation Program.
Sisters Network Holds Walk and Health Fair
to Raise Awareness of Breast Cancer
The recently formed Sisters Network, a support and outreach group for North
Carolina African-American breast cancer survivors, held a walk and health fair
for its members and the community on October 25, 2003. Pictured (left to right)
are: Dr. Mark Graham, UNC oncologist; Carolyn Thornton, co-chair of the
“Gift for Life” Walk; Mary Jackson, chair of the “Gift for Life” Walk and UNC
Bone Marrow and Stem Cell Transplantation Program social worker; and Kim
Huck, UNC oncology nurse and coordinator of the Study of Tamoxifen and
Raloxifene (STAR) breast cancer prevention trial.
Proceeds from a bequest from Phillip
Hettleman, Jr., UNC Class of 1976, who died
of cancer in June 2003 have been used to
establish the Hettleman Fund for Cancer
Research at UNC Lineberger Comprehensive
Cancer Center. Mr. Hettleman worked as a
manager for TD Waterhouse and lived in La
Jolla, California. His estate is still being settled
but the bequest is expected to total over
$1,500,000.
While the gift was unrestricted, the pro-ceeds
from Mr. Hettleman’s estate will support
the Center’s efforts to bring fundamental
knowledge regarding cancer and its progres-sion
to the patient in the form of clinical trials
that test novel approaches to therapy.
In his last conversation with Shelley Earp,
Linebeger director, Phil discussed his personal
experience and the paucity of appropriate
clinical trials for his disease. He understood the
regulatory burden and increasing expense of
clinical trials, the teamwork necessary to build
a trials group and the need for a great Uni-versity
faculty to create new avenues for clinical
success.
According to Earp, Phil’s legacy “will have
an enormous impact on our ability to bring
new ideas from the laboratory to the patient
and to test them rigorously through clinical
trials. The Hettleman Fund will help our
faculty test novel cancer therapies and, most
importantly for groundbreaking ideas in
human disease treatment, determine not only
whether they work but why they work or why
they fail.”
The Hettleman family had a long association
with UNC and Phil talked specifically of his
parents’ love for the University. Phil’s parents,
Phillip Hettleman ’21 and Ruth Rea Hettleman,
established the Hettleman Prize, the Hettleman
Chair in Business School, and the Hettleman
Young Faculty Awards. Phil’s father and his
stepbrother, Thomas Hettleman ’56, also died
of cancer. Directing this major legacy from Phil
Hettleman, Jr.’s life work to support clinical
trials and translational cancer research at UNC
seems a most fitting tribute to Phil and his
family.•
Center Receives $1.5 Million
Bequest from PhillipHettleman, Jr.
New Prostate Cancer Surgery
Procedure Offered At UNC
Hospitals
Prostate cancer patients at UNC have a new surgi-cal
option. Rather than undergoing the traditional
radical prostatectomy, they may choose to have the
procedure done laparoscopically, which can reduce
recovery time as well as post-operative pain.
Currently, UNC Hospitals is the only medical cen-ter
in the area offering this procedure.
“Having a prostatectomy done laparoscopically
means less post-operative pain and a shorter recov-ery
time,” said Eric Wallen, assistant professor of
surgery and a Lineberger Center member. “With
the traditional surgery, the recovery period is usual-ly
six to eight weeks, whereas following the laparo-scopic
procedure, the time is reduced to two
weeks. There is also less need for blood transfusion
during surgery.”
For Wallen, another advantage is what he is able
to see. Like the traditional surgery, the new proce-dure
carries a similar risk of incontinence and im-potence.
However, Wallen says, “I have a better
view of the edges of the prostate and the nerves
that are so crucial to the preservation of erections.”
Anyone with a prostate cancer confined only to the
prostate is a candidate for this procedure.
For further information about this procedure or
to make an appointment, please call (919) 966-
9696.•
Briefs
continued from page 4
8 cancerLines Spring 2004
Chemotherapy and Radiation
Combination therapy prior to surgery is now
standard therapy for patients with moderately ad-vanced
tumors still localized to the pelvis. “The
challenge is to make the non-surgical portion of the
therapy even more effective to increase the chance
of preserving the normal anus and sphincter func-tion
as well as decreasing the chance of the tumor
recurring, all while minimizing the side effects from
the therapy,” states Joel Tepper, chair of radiation
oncology at UNC and one of the leaders of the
Multidisciplinary GI Group.
Some rectal tumors are even more advanced in
the pelvis, so that surgery alone is unlikely to pro-duce
a cure. UNC physicians use specialized radia-tion
techniques to give a boost—or extra—dose
of radiation during surgery, where the radiation
would be less likely to damage adjacent normal
tissues but better able to control the tumor. These
intraoperative radiation therapy techniques (IORT)
have proven useful in many situations where con-ventional
therapy is not sufficient to give a good
chance of controlling the disease. UNC Lineberger
is one of the few centers in the U.S. to have dedi-cated
intraoperative radiation therapy.
Molecular Biology Research
Other innovative research involves studying tumor
molecular profiles—called microarrays—that de-tect
the molecular signature of the rectal tumor.
“If we can profile the tumor, we’ll be better able to
give the patient something that works with their
tumor’s characteristics,” Perou notes. Perou is assis-tant
professor of genetics at UNC.“We hope that
this approach will make the treatment more effec-tive,
speeding recovery.”
Combination Therapies
Bert O’Neil, assistant professor of medicine and GI
cancer program member, is leading a team investi-gating
the use of a new kind of drug (Velcade) with
fewer side effects than typical chemotherapy agents
that, when teamed with radiation therapy, will po-tentially
result in a more effective combination treat-ment
without increasing the side effects drama-tically.
“We will be the first center to pair Velcade
with both chemotherapy and radiation in rectal can-cer,”
O’Neil notes. The team is looking at biologic
therapies based on new molecular advances. Com-bined
with radiation therapy, these innovative
chemotherapy agents could prove more effective
than standard treatment. Currently, patient accrual
to a clinical trial using these drugs is just beginning.
As summarized by Dr. Tepper, “our overall goal
is to design therapies directed for the individual
patient which have a better chance of controlling the
tumor while minimizing both the acute and the
long-term side effects. This requires a combination
of understanding the basic biology of the tumor as
well as the best manner in which to individualize the
use of these therapies for each patient.”
For more information about the clinical trials men-tioned
in this story, please call the Protocol Office at
919-966-4432 or toll-free 877-668-0683.•
UNC Lineberger Honors
2003 Oncology Nursing Excellence Award Winners
2003 Oncology Nursing Excellence Award winners were honored at the fall UNC Lineberger Board of Visitors
meeting and at a January 8 reception. Jerome Schiro, who works in the adult outpatient Hematology/Oncology
clinic, won the Charmayne S. Gray Award. The award is named in memory of UNC Lineberger nurse practi-tioner
Charmayne Gray who died in an automobile accident. Michele Busshart, who works in the Hematology/
Oncology medicine unit, won the inpatient award.
The Oncology Nursing Excellence Awards are given in recognition of the nurses’ extraordinary hard work,
care and dedication that they bring to the field each day. Pictured, left to right: Jerome Schiro, Dr. Earp, and
Michele Busshart.
Innovative Research
to Treat Rectal Tumors
continued from page 2
The late legendary basketball coach and ESPN sportscaster
Jim Valvano established The V Foundation for Cancer Re-search
in 1993 to support cancer research and create greater
public awareness of the importance of working to eradicate
cancer.
Working with ESPN, The V Foundation sponsors the
Jimmy V Women’s Basketball Classic, which features the best
women’s college basketball teams in the country and brings
attention to the importance of cancer research.
A portion of the proceeds from the 2003 Jimmy V Classic
held on November 23, 2003, at the RBC Center in Raleigh
was used to fund breast cancer research being conducted by
Dr. Carolyn Sartor, co-leader of the UNC Breast Center. Carolyn accepted her award on national TV at half-time
of the Purdue vs. Duke game.
The V Foundation also has a “V Scholars” program that provides funding for research projects being
conducted by some of the brightest laboratory scientists pursuing basic cancer research. UNC Lineberger is
proud that both Kim Rathmell and Jason Lieb, new young professors at UNC and Lineberger faculty, are
recipients of these two-year, $100,000 V Scholars grants.•
TheV Foundation–
A Slam-Dunk for
Cancer Research
2004 Lineberger
Club Luncheon and
Basketball Game
The 2004 Lineberger Club
lunch and winning basketball
game against UConn was a big
success. The lunch is held in
recognition of Lineberger Club
members who give an annual
gift of at least $1,000 to the
Center.
Sponsors for the event were:
Lee-Moore Oil Company, Stock
Building Supply, Sprint, Cafe
Carolina and Wachovia. Speakers were Dr. Patricia Rivera, assistant professor of
medicine and member of the Multidisciplinary Thoracic Oncology Program
(MTOP), and Katherine Wilson, a UNC Nursing School student from Morgan-ton,
NC, and lung cancer patient.
Katherine is shown in the top photo with her family (front, left to right): mother,
Anne Wilson; Katherine; boyfriend Brian Wood; (standing, left to right): brother,
Fletcher; father, John; and brother, J.D.
Lower left photo (left to right): Lineberger Board member John Burress of
Winston-Salem auctioned off the basketball signed by the UNC men’s team and
coaches. The winners were Flo and Charles Winston of Raleigh.
cancerLines Spring 2004 9
Scrapbook
Sibling Donates Marrow to Two Other Brothers;
Donor: ‘It has a been a blessing for my family’
Mike Bednar of Pittsboro, NC, and his brother Martial of Rochester, NY, share
more than the family name. They share an immune system, thanks to Martial’s
donation to Mike, who needed a transplant to treat his multiple myeloma.
When Martial’s marrow type proved a perfect match for Mike, it would be the
second time for Martial and what is believed to be the first time in the United
States that an adult donor had given marrow to two siblings.*
In 1996, Martial first donated his marrow to his brother Merrick, a Roman
Catholic priest who had a lengthy and complicated medical history of cancer
and heart disease and who died awaiting a second heart transplant.
In summer 2003, Martial donated his marrow again, this time to his eldest
brother, Mike, who received it in November as part of a clinical trial sponsored by
Cancer and Leukemia Group B (CALGB) through the Lineberger Protocol Office.
Dr. Don Gabriel, professor of medicine in UNC’s School of Medicine and
member of the Lineberger Center, is Mike Bednar’s physician.“When you’re
facing a deadly disease as Mike Bednar is, hope is inexorably linked to an
available donor. Mike is fortunate that his brother was a perfect match. But not
everyone has a brother who is a perfect match.
“Being a donor takes time out of your life; it’s not something you have to do.
Donors are heroes as well as the recipient and the families. Martial Bednar’s
experience as a donor shows that it’s not dangerous. He’s done it twice!
“We hope that people will consider getting registered with the National
Registry. They can save someone’s life. The more potential donors we have in
the registry, the greater the chance that a match can be found for a patient.”
*The United Network for Organ Sharing, the University of California at Los Angeles Immuno-genetics
Center and the Fred Hutchinson Cancer Research Center revealed no other known instances
of a donor giving marrow to two different siblings. The International Bone Marrow Transplant
Registry was contacted, but does not track such data.
Great Human Race
UNC Lineberger was the only UNC group
participating in the Great Human Race, a
fundraising event organized by the Volunteer
Center of Durham held on Saturday, March 27 at
the Durham Bulls Athletic Park.
The 16-member team of walkers raised close
to $2,000 for cancer research at UNC
Lineberger. Pictured getting warmed up for the
walk are (left to right): Michelle Johnson, Mia
Jones, Megan Crow, Lisa Miser. and Amy
Mansfield.
10 cancerLines Spring 2004
caolfe nedvaernts
A p r i l 2 4
UNC Lineberger Beach Ball. University Mall,
Chapel Hill, NC. For more information:
http://unclineberger.org
J u n e 1 2
NC Triangle Susan G. Komen Breast Cancer
Foundation Race for the Cure. Raleigh, NC.
S e p t e m b e r 1 8
Leukemia & Lymphoma Society Light the
Night. Raleigh, NC.
S e p t e m b e r 2 1
Gynecologic Cancer Awareness Luncheon.
Cary, NC.
S e p t e m b e r 2 4
Board of Visitors. Lineberger Cancer Center,
Chapel Hill, NC.
O c t o b e r 7
Pretty ’n Pink Women’s Cancers Luncheon.
Squid’s Restaurant, Chapel Hill, NC.
UNC Lineberger Comprehensive Cancer Center
CB# 7295
School of Medicine
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599-7295
(919) 966-3036
http://unclineberger.org
Return Forwarding, and Return Postage Guaranteed.
Address Correction Requested.
Nonprofit Organization
U.S. Postage
PAID
Permit No. 71
Chapel Hill, NC 27599-1110
New NC Cancer Hospital Plans Continue
Architects have
continued planning
for the proposed
new NC Cancer
Hospital pending
authorization by the
NC General Assem-bly.
Funding for the
over 300,000
square foot hospital
will be considered
by legislators during
the upcoming short
session beginning
in May 2004.
Over 50 groups
have been meeting
with the architects
to plan a facility that will make UNC Lineberger and its clinical program among the most advanced in
the nation. It has been exciting for these multiple groups—patients, oncology nurses, physicians,
support personnel and other staff—to participate in this planning process. The building will face a new
green space developed once the existing Gravely Building is torn down. The new building will connect
through the lobby spaces for NC Women’s, Children’s, Neurosciences and NC Memorial Hospitals.
A clinical cancer office building will be constructed directly across Manning Drive.•
The United States Department of
Defense Prostate Cancer Research
Program has awarded a $9.9 million
grant to a new consortium of top U.S.
cancer researchers trying to discover
why prostate cancer deaths are more
than twice as common in black men
as in white men and why such deaths
also vary significantly from state to
state. Dr. James Mohler of UNC
Lineberger and Roswell Park Cancer
Institute will serve as consortium
director of the three-year study. This
project and others examining prostate
cancer will be featured in the fall issue
of Cancer Lines.
Grant Awarded
for New Cancer
Research
MANNING DRIVE
EXISTING UNC HOSPITALS